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June 2015; 2 (3) ArticleOpen Access

Clinical course and treatment of anti-HMGCR antibody–associated necrotizing autoimmune myopathy

Sudarshini Ramanathan, Daman Langguth, Todd A. Hardy, Nidhi Garg, Chris Bundell, Arada Rojana-Udomsart, Russell C. Dale, Thomas Robertson, Andrew L. Mammen, Stephen W. Reddel
First published April 2, 2015, DOI: https://doi.org/10.1212/NXI.0000000000000096
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Article Information

vol. 2 no. 3 e96
DOI: 
https://doi.org/10.1212/NXI.0000000000000096
PubMed: 
25866831
Published By: 
Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology
Online ISSN: 
2332-7812
History: 
  • Received August 24, 2014
  • Accepted in final form January 20, 2015
  • First Published April 2, 2015.
Copyright & Usage: 
© 2015 American Academy of Neurology This is an open access article distributed under the terms of the Creative Commons Attribution-Noncommercial No Derivative 3.0 License, which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially.

Author Disclosures

    1. Sudarshini Ramanathan, FRACP,
    2. Daman Langguth, FRACP, FRCPA,
    3. Todd A. Hardy, FRACP, PhD,
    4. Nidhi Garg, MBBS,
    5. Chris Bundell, PhD,
    6. Arada Rojana-Udomsart, PhD,
    7. Russell C. Dale, PhD,
    8. Thomas Robertson, FRCPA,
    9. Andrew L. Mammen, MD, PhD and
    10. Stephen W. Reddel, FRACP, PhD
  1. Sudarshini Ramanathan, FRACP,
    2. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. Sudarshini Ramanathan has received a scholarship from the National Health and Medical Research Council (Australia)

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  2. Daman Langguth, FRACP, FRCPA,
    3. Scientific Advisory Boards:

    1. Tocilizumab in asthma phase 1 trial, university of Queensland, not for profit.

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. Speakers fees for Roche on off label use of rituximab

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. Sullivan Nicolaides Pathology, director of immunology, 8 years

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NHMRC development grant for Grass allergy research (Pas n 1 sIgE test)

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  3. Todd A. Hardy, FRACP, PhD,
    4. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. Advances in Clinical Neuroscience, Associate Editor, 2013-2014

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  4. Nidhi Garg, MBBS,
    5. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. Current position as Neuromuscular Fellow at Concord Hospital is partly funded by the drug company, Allergan.

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  5. Chris Bundell, PhD,
    6. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  6. Arada Rojana-Udomsart, PhD,
    7. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  7. Russell C. Dale, PhD,
    8. Scientific Advisory Boards:

    1. Queensland Children's Medical Institute Research advisory committee. Not for profit.

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. received an honoraria for lecturing from Biogen Idec

    Editorial Boards:

    1. Editorial advisory board member of MSARD Editorial board member of Neurology: Neuroimmunology and Neuroinflammation Editorial board member of European Journal of Paediatric Neurology

    Patents:

    1. NONE

    Publishing Royalties:

    1. Biogen Idec 1000 dollar honoria in 2008

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NHMRC national grant in 2011 national grant for encephalitis study NHMRC practitioner fellowship 2014-8 NHMRC project grant 2015

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  8. Thomas Robertson, FRCPA,
    9. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  9. Andrew L. Mammen, MD, PhD and
    10. Scientific Advisory Boards:

    1. aTYR pharmaceuticals advisory board Biogen advisory board

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. Experimental Neurology, Editorial Board, 2013-Arthritis and Rheumatism, Editorial Board, 2014-

    Patents:

    1. Patented test for anti-HMGCR antibodies that is licensed to INOVA diagnostics

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NIH, K08

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. Licensed test for anti-HMGCR antibodies to INOVA Diagnostics

    Royalty Payments, Technology or Inventions:

    1. Licensed test for anti-HMGCR antibodies to INOVA Diagnostics

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  10. Stephen W. Reddel, FRACP, PhD
    11. Scientific Advisory Boards:

    1. 1. CSL 2. Baxter 3. Genzyme 4. Biogen 5. National Immunoglobulin Governmental Advisory Council, Australia

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. 1. CSL 2. Genzyme 3. Biogen

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NSW Health, Australia

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. 1. Genzyme

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. Beeren Foundation

    Stock/Stock Options/Board of Directors Compensation:

    1. 1. Sydney Neurology 2. Medical Safety Systems

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  1. From the Department of Neurology (S.R., T.A.H., N.G., S.W.R.), Concord Repatriation General Hospital, Sydney, New South Wales, Australia; Neuroimmunology Group (S.R., R.C.D.), Institute for Neuroscience and Muscle Research, The Kids Research Institute at the Children's Hospital at Westmead, Sydney Medical School, University of Sydney, New South Wales, Australia; Department of Neurology (S.R.), Westmead Hospital, Sydney, New South Wales, Australia; Sullivan Nicolaides Pathology (D.L.), Brisbane, Queensland, Australia; Concord Clinical School (T.A.H., S.W.R.), University of Sydney, New South Wales, Australia; Clinical Immunology (C.B.), PathWest, QEII Medical Center, Nedlands, Western Australia, Australia; School of Pathology and Laboratory Medicine (C.B.), University of Western Australia, Nedlands, Western Australia, Australia; Australian Neuro-Muscular Research Institute (ANRI) and Centre for Neuromuscular and Neurological Disorders (CNND) (A.R.-U.), University of Western Australia, QEII Medical Centre, Nedlands, Western Australia, Australia; Pathology Queensland (T.R.), Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia; and National Institute of Arthritis and Musculoskeletal and Skin Diseases (A.L.M.), National Institutes of Health, Bethesda, MD.
  1. Correspondence to Dr. Reddel: swreddel{at}sydneyneurology.com.au
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